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Potential fraud found after ride company over-billed state, auditor says

MassHealth’s largest vendor for non-emergency transportation improperly billed the state for more than $16 million dollars in rides, putting in for more expensive wheelchair van claims when instead the clients were almost all able to walk, according to a report released Monday afternoon by State Auditor Suzanne M. Bump.

Potential fraud found after ride company over-billed state, auditor says

MassHealth’s largest vendor for non-emergency transportation improperly billed the state for more than $16 million dollars in rides, putting in for more expensive wheelchair van claims when instead the clients were almost all able to walk, according to a report released Monday afternoon by State Auditor Suzanne M. Bump.

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Updated: 6:30 PM EDT Oct 5, 2015

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WEBVTT INVESTIGATES KATHY CURRAN TOLD YOU ABOUT AND SHE HAS THE LATEST ON THIS COMPANY TONIGHT. I THINK THIS IS A CASE OF DELIBERATE WRONGDOING. Reporter: THEY SAY THE MEDICAL TRANSPORT COMPANY WHICH WAS FIRST EXPOSED BY 5 INVESTIGATES BUILDS NEARLY $17 MILLION FOR TWO YEARS WORTH OF WHEELCHAIR VAN RIDES EVEN THOUGH ALL OF THEIR CLIENTS CAN WALK. IF YOU ARE GOING TO PROVIDE WHEELCHAIR SERVICE IT HAS TO BE MEDICALLY NECESSARY AND THERE WAS NO NECESSITY. 95% OF THE CLIENTS REPRESENTED IN THE $17 MILLION WORTH OF BILLINGS WERE AMBULATORY. THEY FOUND RIGHT WAY WAS PAID MORE THAN $27,000 FOR RIDES THAT NEVER HAPPENED BECAUSE THE CLIENTS THEY WERE SUPPOSED TO BE DRIVING WERE HOSPITALIZED. AND MORE THAN $6,000 WAS PAID FOR METHADONE CLINICS WHEN THAT TREATMENT WAS GIVEN. IT WAS TOTALLY WRONG RIGHT FROM THE GET GO. Reporter: OTHER THAN ON RARE OCCASIONS OF HUMAN ERROR HE WASN'T CHARGED FOR SERVICES IT DID NOT PROVIDE OR ENGAGED IN FRAUDULENT OR IMPROPER ACTIVITY. THEY UPGRADED THE INTERNAL CONTROLS AND ALSO SAYS MASS HEALTH TOLD THEM TO BILL THE STATE FOR WHEELCHAIR VANS. IT IS A CLAIM MASS HEALTH DENIES. THE AUDITOR'S REPORT ISN'T THE END OF THE ROAD WHEN IT COMES TO PROBLEMS FOR RIGHT WAY. THE ATTORNEY GENERAL'S OFFICE IS ALSO INVESTIGATING. SOURCES TELL US THAT THEY ARE LOOKING INTO WHETHER THE COMPANY BILLED FOR SERVICES NO THE PROVIDED, AND IF THEY OFFERED CASH AND REFERRAL BONUSES FOR CLIENTS. THE AUDITOR IS CALLING FOR RIGHT WAY TO PAY THE MILLIONS IN QUESTION BACK. IT IS A PRETTY EGREGIOUS

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Potential fraud found after ride company over-billed state, auditor says

MassHealth’s largest vendor for non-emergency transportation improperly billed the state for more than $16 million dollars in rides, putting in for more expensive wheelchair van claims when instead the clients were almost all able to walk, according to a report released Monday afternoon by State Auditor Suzanne M. Bump.